Molecular testing in urinary cytology specimens: Current status and future directions

Area of Science:

• Urology
• Oncology
• Molecular Diagnostics

Background:

• Bladder cancer presents high recurrence and mortality rates, necessitating improved diagnostic tools beyond cystoscopies.
• Current noninvasive urinary cytology shows high specificity but low sensitivity for detecting low-grade bladder tumors.
• Advancements in molecular techniques drive the search for urinary biomarkers for comprehensive bladder cancer management.

Purpose of the Study:

• To evaluate the utility of urinary biomarkers for bladder cancer diagnosis and monitoring.
• To review technological innovations in urine-based liquid biopsy and artificial intelligence for cytopathology.
• To discuss the integration of molecular cytopathology into clinical practice for precision medicine.

Main Methods:

• Comprehensive literature review of urinary biomarkers and technological innovations.
• Analysis of urine-derived materials including morphological, transcriptomic, epigenetic, and genomic data.
• Evaluation of current diagnostic and monitoring applications in bladder cancer.

Main Results:

• Urinary biomarkers provide noninvasive access to exfoliated cells for molecular analysis.
• Technological advancements enhance the potential for early detection and risk stratification.
• Molecular cytopathology shows promise for minimal residual disease detection and therapeutic response monitoring.

Conclusions:

• Urinary biomarkers and advanced technologies are crucial for improving bladder cancer detection and management.
• Integrating molecular cytopathology into clinical practice faces challenges but offers significant prospects.
• Precision cytopathology using urinary biomarkers represents a key focus for future bladder cancer research and guidelines.